Evaluating oral swab samples for PRRSV surveillance in weaning-age pigs under field conditions.

Introduction: The use of serum and family oral fluids for porcine reproductive and respiratory syndrome virus (PRRSV) surveillance in weaning-age pigs has been previously characterized. Characterizing more sample types similarly offers veterinarians and producers additional validated sample options for PRRSV surveillance in this subpopulation of pigs. Oral swab sampling is relatively easy and convenient; however, there is sparse information on how it compares to the reference sample type for PRRSV surveillance under field conditions. Therefore, this study's objective was to compare the PRRSV reverse-transcription real-time polymerase chain reaction (RT-rtPCR) test outcomes of oral swabs (OS) and sera samples obtained from weaning-age pig litters. Method: At an eligible breeding herd, six hundred twenty-three weaning-age piglets from 51 litters were each sampled for serum and OS and tested for PRRSV RNA by RT-rtPCR. Results and Discussion: PRRSV RT-rtPCR positivity rate was higher in serum samples (24 of 51 litters, 83 of 623 pigs, with a mean cycle threshold (Ct) value of RT-rtPCR-positive samples per litter ranging from 18.9 to 32.0) compared to OS samples (15 of 51 litters, 33 of 623 pigs, with a mean Ct of RT-rtPCR positive samples per litter ranging from 28.2 to 36.9); this highlights the importance of interpreting negative RT-rtPCR results from OS samples with caution. Every litter with a positive PRRSV RT-rtPCR OS had at least one viremic piglet, highlighting the authenticity of positive PRRSV RT-rtPCR tests using OS; in other words, there was no evidence of environmental PRRSV RNA being detected in OS. Cohen's kappa analysis (Ck = 0.638) indicated a substantial agreement between both sample types for identifying the true PRRSV status of weaning-age pigs.

Validation of the College Planning Behaviors Scale.

College preparation is an important topic in the educational attainment of high school students. Much of the research on college planning focuses on the importance and timing of preparing for postsecondary education; however, little research has explored the steps students actually take while preparing for college. The current study utilized the Social Cognitive Career Theory (SCCT) framework to create a validated measure to assess choice behavior. The purpose of the current study was to create a validated measure for choice actions that could be used with diverse student groups. The measure was found to demonstrate good reliability and validity in this population, providing strong internal consistency and construct validity. Further, these findings support college-planning behaviors' linkage to barriers, college-going self-efficacy, and college outcome expectations (COE).

Value for money: A utilization-focused approach to extending the foundation and contribution of economic evaluation.

Value for Money (VfM) is an evaluative question about the merit, worth, and significance of resource use in social programs. Although VfM is a critical component of evidence-based programming, it is often overlooked or avoided by evaluators and decision-makers. A framework for evaluating VfM across the dimensions of economy, effectiveness, efficiency, and equity has emerged in response to limitations of traditional economic evaluation. This framework for assessing VfM integrates methods for engaging stakeholders in evaluative thinking to increase acceptance and utilization of evaluations that address questions of resource use. In this review, we synthesize literature on the VfM framework and position it within a broader theory of Utilization-Focused Evaluation (UFE). We then examine mechanisms through which the VfM framework may contribute to increased evaluation use. Finally, we outline avenues for future research on VfM evaluation.

Evaluating unintended program outcomes through Ripple Effects Mapping (REM): Application of REM using grounded theory.

Several evaluation models exist for investigating unintended outcomes, including goal-free and systems evaluation. Yet methods for collecting and analyzing data on unintended outcomes remain under-utilized. Ripple Effects Mapping (REM) is a promising qualitative evaluation method with a wide range of program planning and evaluation applications. In situations where program results are likely to occur over time within complex settings, this method is useful for uncovering both intended and unintended outcomes. REM applies an Appreciative Inquiry facilitation technique to engage stakeholders in visually mapping sequences of program outcomes. Although it has been used to evaluate community development and health promotion initiatives, further methodological guidance for applying REM is still needed. The purpose of this paper is to contribute to the methodological development of evaluating unintended outcomes and extend the foundations of REM by describing steps for integrating it with grounded theory.

Risk Factors Associated With Severe Hypoglycemia in Older Adults With Type 1 Diabetes.

OBJECTIVE: Severe hypoglycemia is common in older adults with long-standing type 1 diabetes, but little is known about factors associated with its occurrence. RESEARCH DESIGN AND METHODS: A case-control study was conducted at 18 diabetes centers in the T1D Exchange Clinic Network. Participants were ≥60 years old with type 1 diabetes for ≥20 years. Case subjects (n = 101) had at least one severe hypoglycemic event in the prior 12 months. Control subjects (n = 100), frequency-matched to case subjects by age, had no severe hypoglycemia in the prior 3 years. Data were analyzed for cognitive and functional abilities, social support, depression, hypoglycemia unawareness, various aspects of diabetes management, C-peptide level, glycated hemoglobin level, and blinded continuous glucose monitoring (CGM) metrics. RESULTS: Glycated hemoglobin (mean 7.8% vs. 7.7%) and CGM-measured mean glucose (175 vs. 175 mg/dL) were similar between case and control subjects. More case than control subjects had hypoglycemia unawareness: only 11% of case subjects compared with 43% of control subjects reported always having symptoms associated with low blood glucose levels (P < 0.001). Case subjects had greater glucose variability than control subjects (P = 0.008) and experienced CGM glucose levels <60 mg/dL for ≥20 min on 46% of days compared with 33% of days in control subjects (P = 0.10). On certain cognitive tests, case subjects scored worse than control subjects. CONCLUSIONS: In older adults with long-standing type 1 diabetes, greater hypoglycemia unawareness and glucose variability are associated with an increased risk of severe hypoglycemia. A study to assess interventions to prevent severe hypoglycemia in high-risk individuals is needed.

Trends in enteric disease as a cause of death in the United States, 1989-1996.

The authors examined rates of and trends in enteric disease as a cause of death in the United States. The National Center for Health Statistics Multiple Cause of Death databases for 1989-1996 were analyzed for International Classification of Diseases, Ninth Revision, codes for gastroenteritis due to infectious agents and codes describing illness with other enteric pathogens. The highest rates of death related to enteric diseases were seen among people older than 75 years, followed by children under 1 year of age. Rates increased markedly over time in the 65- to 74-year age group for bacterial enteric pathogens and in the 35- to 44-year age group for viral enteric pathogens. Enteric diseases were the underlying cause of death for an average of 2,740 deaths during each year of this study, and the rate of death due to enteric-related disease is increasing.